What are Orthotics and What Do They Do?

Orthotics are devices that are inserted into shoes or worn on the outside of shoes to correct biomechanical foot and lower limb deformities or alleviate pain. Common conditions that orthotics can treat include flat feet, bunions, hammertoes, plantar fasciitis, and Achilles tendonitis. Orthotics can also be used to prevent injuries in people who are at risk of developing them due to a biomechanical imbalance.

How Do Orthotics Work?


Orthotics work by altering the way your foot hits the ground when you walk or run. They do this by changing the angles at which your joints move, which in turn changes the way your muscles and tendons work. For example, if you have flat feet, orthotics can be used to raise your arch and prevent your foot from rolling inward when you walk or run. This prevents pain in your feet, ankles, knees, and hips and reduces your risk of developing degenerative joint diseases such as osteoarthritis.

Many modifications can be added to an orthotic to account for the biomechanical nuances that a patient has in the foot, ankle, and leg.

Types of Orthotics


There are two main types of orthotics: custom-made and off-the-shelf. Custom-made orthotics are made from a plaster cast or digital scan of your foot and are designed specifically for you. Off-the-shelf orthotics, on the other hand, are mass-produced and come in a range of sizes. Both custom-made and off-the-shelf orthotics can be made from either rigid or soft materials. Rigid orthotics are generally made from plastic or carbon fiber and provide more support than soft orthotics. Soft orthotics, on the other hand, are made from materials such as foam or gel and provide more cushioning than rigid orthotics.

The type of orthotic you need will depend on the severity of your condition and whether you require more support or cushioning.

Examples of orthotic modifications

  1. Heel Lift – one common underdiagnosed condition is a limb length discrepancy. This is when one of the legs is longer or shorter than the other. Typically the other extremity will compensate and the compensation changes within the foot and ankle could potentially cause pain. A heel lift can be applied to the shorter limb which essentially will bring the foot back down to the ground and can cause a decreased need for compensation. As such, if the compensation changes are causing pain, the pain should be relieved.
  2. 1st Ray Cut-out – This is a modification made to the hard shell of the orthotic where the first metatarsal head is offloaded. This allows for pressure reduction underneath the metatarsal head and can also be helpful in disorders in which there is the limited motion of the great toe joint. This can also help relieve a painful sesamoid with sesamoiditis.
  3. Metatarsal Bar – This is padding added to the area just before the metatarsal heads and can redistribute pressure away from the metatarsal heads onto the metatarsal shafts. It is useful for the treatment of metatarsalgia, neuromas, plantar plate tears, and hammertoes.

Orthotics are devices that support or improve the function of joints and muscles. They can be used to treat a wide range of problems and help reduce pain, improve mobility, and prevent further injury. We offer both off-the-shelf devices in the office which are typically reasonable for most foot and ankle conditions. When a custom-made device is required, the patient is digitally cast and the device will be made from scratch according to the casting model and the doctor’s prescription.